A 70 year-old male presents to his cardiologist’s office with complaints of feeling fatigued and “lousy”. His past medical history is significant for HTN and HL, but until a recent hospitalization, he was non-compliant with his outpatient medical regimen. Of note, he also has a history of heavy alcohol consumption and a 30 pack-year smoking history. The patient reports that he was recently discharged after acute myocardial infarction (AMI) from an outside hospital. At that time, he underwent a diagnostic cardiac catheterization, but no intervention was performed secondary to 100% RCA stenosis and technical difficulties. He was sent home on clopidogrel, aspirin, metoprolol, lisinopril and simvastatin. He currently appears tired and anxious, however he has no symptoms of chest pain, dyspnea, orthopnea, diaphoresis, or lightheadedness; he does report that his primary symptoms leading him to admission was chest pain and shortness of breath.